Susie-Motor Neuron Disease-(Canada)

Name: Susie
Sex: Female
Nationality: Canadian
Age: 54Y
Diagnosis: 1. Motor Neuron Disease(MND) 2, Hypertension
Discharge Date: 2018/10/14

Before treatment:
The patient felt weak in her right thumb in 2014 and the other four fingers became weak gradually too, it was hard for her to grasp and she also felt pain and numbness in her right hand. She went to a local hospital and was diagnosed with carpal tunnel syndrome. Her condition still got worse and her right arm became weak too so she went to hospital more than once and did some treatments but her condition was not improved. 6 months ago her left arm became weak too and this time she was diagnosed with MND. At present both her hands are weak and sometimes she can’t take care of herself.
Her spirit is not so good, her sleep, urination and defecation functions are normal. She has had hypertension for many years.

Admission PE:
Bp: 150/70mmHg, Hr: 71/min, breathing rate: 18/min, body temperature: 36.3 degrees. Height 162cm, weight 63 Kg. Nutrition status is good with normal physical development. There is no injury or bleeding spots of her skin and mucosa, no blausucht, no throat congestion and her tonsils do not have swelling. Chest development was normal, her chest movement range was normal when she was breathing and the respiratory sounds in her lungs were clear with no dry or moist rales. The heart beat is powerful with regular cardiac rhythm and no obvious murmur in the valves. The abdomen was bulging and soft with no masses or tenderness. The liver and spleen were normal and there was no edema of the legs.

Nervous System Examination:
Patient was alert, had clear speech, her memory, comprehension and calculation abilities were normal . Both pupils were equal in size and round, diameter of 3 mm, the reaction to light was sensitive, there was no nystagmus and her eyeballs can move freely. The bilateral forehead wrinkle and nasolabial fold are symmetrical, she can close eyes powerfully,  make her tongue extend out normally, there was no tongue muscle tremor or atrophy and the tongue muscle could move with flexibility. Showing teeth was normal, the soft palate could lift powerfully, the uvula was in middle position, there was no swallowing difficulty, no choking symptoms and the pharyngeal reflex was normal. The patient could not raise her head up, turn her neck or shrug powerfully. The right arm muscle power was 3- degrees, abductor muscle power was 3- degrees, adductor muscle power was 2+ degrees and the right hand grip force was 3- degrees. The left arm muscle power was 4- degrees, abductor muscle power was 4 degrees, adductor muscle power was 3- degrees and the left hand grip force was 4 degrees. Her leg muscle power was 4+ degrees. There was middle muscle atrophy of her arms, hands interphalangeal muscles, thenar muscles, biceps muscles, triceps muscles, shoulder, neck and back muscles groups. The 4 limbs muscle tone were normal, the arm tendon reflex could not be induced, tendon reflex of the legs was reduced and the abdominal reflex was reduced also. The bilateral palm-jaw reflex, the sucking reflex, bilateral Hoffman sign, Rossilimo sign and Babinski sign of both sides were all negative. The sensory system examination was normal by gross measure. She could perform the finger to nose test, fast alternate movement slowly and the hands can perform the finger opposite movement except for the little fingers. The heel-knee-tibia test was stable and accurate, the meningeal irritation sign was negative.

Treatment:
After the admission she received 3 nerve regeneration treatments (neural stem cells and mesenchymal stem cells) to repair her damaged nerves,improve body environment (edaravone) replace dead nerves, nourish nerves(Gangliosides and neurotrophic factors), regulate her immune system and improve blood circulation. This was combined with rehabilitation training.     

Post-treatment:
After 14 days treatment her endurance improved, the arm muscle power improved with the right arm muscle power now 3 degrees, abductor muscle power 3 degrees, adductor muscle power 2+ degrees and the right hand grip force 3 degrees. The left arm muscle power was 4 degrees, abductor muscle power 4 degrees, adductor muscle power 3 degrees and the left hand grip force was  now 4+ degrees.  Her legs can now move faster.